Professor Mashiko Setshedi – Head of Medicine at the University of Cape Town and Groote Schuur Hospital

This week on Womanity, Dr Amaleya Goneos-Malka speaks with Professor Mashiko Setshedi, Head of the Department of Medicine at the University of Cape Town and Groote Schuur Hospital, she is a leading gastroenterologist, educator, and researcher shaping the future of healthcare in South Africa and developing the next generation of healthcare professionals.

From Aspiring Lawyer to Medical Leader

Prof. Setshedi shares the unexpected path that led her into medicine. Initially intending to pursue a career in law, a medical school acceptance changed the course of her life. What followed was a deep passion for medicine and a career-defining moment when two influential female professors recognised her potential and encouraged her to pursue internal medicine.

Exploring the “Second Brain”: The Fascinating World of Gastroenterology

Prof. Setshedi explains why the gastrointestinal system is often referred to as the body’s “second brain,” emphasising its critical role in immunity, nutrition, disease prevention and overall wellbeing.

She discusses groundbreaking advances in the field, including:

Precision medicine tailored to individual patients.
New treatments for inflammatory bowel disease.
Minimally invasive procedures replacing traditional surgery.
AI-assisted diagnostic technologies that improve accuracy and patient outcomes.

Choosing Leadership Over Comfort

Prof. Setshedi’s reflects on the difficult decision to step away from some of her direct clinical and research ambitions to lead an entire department. While the move required sacrifice, it ultimately aligned with a deeper sense of purpose: creating lasting impact through education, staff development, culture-building and institutional transformation. Her experience illustrates that leadership often requires embracing opportunities before we feel fully ready for them.

Rebuilding Culture Through Compassion and Collaboration

Having inherited a high-performing department, Prof. Setshedi chose not to focus solely on technical excellence. Instead, she identified a deeper need: healing and reconnecting a community affected by years of disruption, including student protests, leadership losses, the COVID-19 pandemic and resource constraints. Her leadership philosophy centres on:

Collaboration over hierarchy.
Listening before directing.
Creating environments where people feel valued and heard.
Building cultures of belonging, trust and inclusion.

She argues that when people feel supported and connected, excellence naturally follows.

Transforming Medical Education for a New Generation

Teaching remains one of Prof. Setshedi’s greatest passions. She speaks candidly about the need to rethink how doctors are trained, moving away from outdated teaching methods based on intimidation and hierarchy.

Her vision for medical education includes:

Human-centred learning.
Greater empathy and cultural competence.
Stronger partnerships between doctors and patients.
Curriculum reform that reflects African realities.
Using AI to streamline learning and reduce information overload.

She believes future healthcare professionals must not only be clinically competent but also deeply compassionate, understanding that medicine is fundamentally a profession of service.

Women in Leadership: Progress and Persistent Challenges

In our discussion on gender representation in medicine, Prof. Setshedi notes that women often equal or outnumber men at undergraduate level, yet remain underrepresented in senior leadership positions. She explores several contributing factors:

Limited succession planning.
Lack of sponsorship and advocacy.
Structural barriers.
Women’s tendency to underestimate their own readiness for leadership roles.

Importantly, she calls for intentional efforts to identify, support and develop future women leaders, emphasising that talent alone is not enough without opportunity and encouragement.

Defining Success on Your Own Terms

When asked about the keys to her success, Prof. Setshedi offers a powerful perspective: success must be personally defined. Rather than measuring achievement through external markers, she encourages individuals to ask:

“Am I a better person today than I was yesterday?”

For her, true success lies in continuous growth, meaningful contribution and service to others. She cautions against comparing oneself to others and instead advocates “running your own race” while remaining true to your values and purpose.

A Message to Young Women Across Africa

Closing the conversation, Prof. Setshedi delivers an uplifting message to girls and young women:

Believe in your abilities.
Do not allow self-doubt to define your future.
Learn from the experiences of others.
Embrace your individuality.
Focus on becoming the best version of yourself.
Seek support when needed and remain open to growth.

Every woman possesses unique gifts and perspectives that the world needs. Success begins when we stop comparing ourselves to others and start believing in our own potential.